Disparities in mammography use among US women aged 40-64 years, by race, ethnicity, income, and health insurance status, 1993 and 2005
Disparities in mammography use among US women aged 40-64 years, by race, ethnicity, income, and health insurance status, 1993 and 2005
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DOI：
10.1097/mlr.0b013e31817893b1
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发表时间：
2008-07-01
期刊：
影响因子：
3
通讯作者：
Shaw, Kate M.
中科院分区：
文献类型：
--
作者：
Sabatino, Susan A.;Coates, Ralph J.;Shaw, Kate M.
目的：研究目的：探讨目前乳腺X线摄影使用的差异，以及不同种族、民族、收入、保险和这些特征组合的差异随时间的变化。研究设计：采用1993年和2005年全国健康访谈调查对乳腺X线摄影使用的横断面调查进行比较。受试者：40-64岁的女性（1993年，n = 4167; 2005年，n = 7434）.措施：前2年内的乳房X光检查.结果：2005年，未投保妇女报告乳房X光检查使用率最低（38.3%）。虽然筛查在低收入、无保险的妇女中增加了6.9个百分点，但1993年至2005年期间，有保险和无保险妇女之间的总体差距没有显著变化。在中等收入、无保险的妇女中，筛查似乎有所减少，与中等收入、有保险的妇女相比，差距差距扩大。1993年美洲印第安人/阿拉斯加土著妇女乳房X线摄影使用率低于白色妇女的情况在2005年不再存在;然而，2005年出现了亚洲妇女乳房X线摄影使用率低于白色妇女的情况。我们发现非裔美国人和白色女性之间没有差异。西班牙裔妇女不太可能比非西班牙裔妇女报告筛查在2005年（58.1%比69.0%）。结论：虽然乳房X线摄影使用增加了一些群体在1993年和2005年之间，低收入，无保险的妇女继续有最低的筛查率在2005年，这组的差距并没有减少。在中等收入、没有保险的妇女中，筛查使用的差距增加了，这是因为即使是没有保险的非贫困妇女，乳房X光检查也可能减少。2005年，亚洲妇女接受筛查的可能性降低。需要继续努力消除差距。特别需要加大努力，解决未投保妇女，包括中等收入未投保妇女长期存在的巨大差距。
Objective: To examine current disparities in mammography use, and changes in disparities over time by race, ethnicity, income, insurance, and combinations of these characteristics.Research Design: Comparison of cross-sectional surveys of mammography use using the 1993 and 2005 National Health Interview Survey.Subjects: Women aged 40-64 (1993, n = 4167; 2005, n = 7434).Measures: Mammogram within prior 2 years.Results: In 2005, uninsured women reported the lowest mammography use (38.3%). Though screening increased 6.9 percentage points among low-income, uninsured women, the overall disparity between insured and uninsured women did not change significantly between 1993 and 2005. Screening seems to have declined among middle-income, uninsured women, increasing the gap compared with middle-income, insured women. The lower mammography use in 1993 among American Indian/Alaska Native compared with white women was not present in 2005; however, lower use among Asian compared with white women emerged in 2005. We found no differences between African American and white women. Hispanic women were less likely than non-Hispanic women to report screening in 2005 (58.1% vs. 69.0%).Conclusions: Although mammography use increased for some groups between 1993 and 2005, low-income, uninsured women continued to have the lowest screening rates in 2005 and the disparity for this group was not reduced. The gap in screening use for middle-income, uninsured women increased, resulting from possible declines in mammography even for uninsured women not in poverty. Asian women became less likely to receive screening in 2005. Continuing efforts are needed to eliminate disparities. Increased efforts are especially needed to address the large persistent disparity for uninsured women, including middle-income uninsured women.